We know that exercise is a lifelong commitment, but up to 70% of chronic back pain patients will stop exercise just a few months after stopping an exercise program. So, what works? What helps patients successfully start an exercise program? The same research gives us some ideas.
High self-locus of control. If you believe you have control over your health, and your back pain, you are more likely to keep exercising. Patients need to be counseled or taught that they have control over much of their health. This concept can be applied to more than just exercise, such as diet, smoking, and other lifestyle modifications.
Actively develop your own exercise program. If you work with a personal trainer or physical therapist to design a program specific to you and your needs, you are more likely to be invested and stick with a new program. Patients should be actively involved in developing a rehab program.
Working with a health care provider or therapist while exercising. It appears that supervision is important for success. This supervisor provides accountability, guidance, and encouragement for someone who otherwise might “fall off the wagon”.
Psychological counseling to work on self-motivation. Patients should ultimately be able to develop the discipline to stick to a new exercise program. They should still have therapists and trainers available to help when they get in trouble; but the ultimate goal is independence in an exercise program.
Money may motivate some patients. In a 1999 study, never-smokers with a BMI of 25 kg/m2 who participated in physical activity 3 days per week had mean annual health care charges that were approximately 49% lower than physically-inactive smokers with a BMI of 27.5 kg/m2. One study showed a health care savings annually, per employee, which translates into $1,434.28 when an employee fitness program is initiated. In the new U.S. health care model, where patients have higher co-pays and deductibles, patients should be interested in decreasing their health care costs simply because it saves them money.
The world is witnessing a growing pandemic of physical inactivity, obesity, and associated morbidity and it doesn’t look like it is slowing down. As physiatrists, we are inherent leaders in this fight, and the more information and resources we can offer our patients, the better chance we have of making a meaningful impact.